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Male breast cancer : why are there delays in diagnosis?

I was interested to read in a recent study conducted as part of the male breast cancer pooling project that men with higher oestrogen levels are at greater risk of developing breast cancer than those whose oestrogen levels are lower.

Whilst breast cancer is commonly thought to be a predominantly female cancer, there are reported to be, on average, 350-400 men diagnosed with the disease in the UK each year. Of these, the vast majority present with stage 4 or 5 cancer by which time their future prognosis may be poor. This is in stark contrast to women who are often diagnosed whilst the cancer is still at stage 1 or 2. This has caused me to question why the symptoms of male breast cancer are so often ignored and whether more can be done to help.

What are the symptoms of male breast cancer?

Although breast cancer in men is rare, it is just as important for men to be on the lookout for the symptoms as for women.

It is recommended by Cancer Research UK that men should see their GP as soon as possible if they notice any lumps around the nipple area as well as anything unusual about their nipple.  Specifically, men should be looking for the following:

1. A lump behind or near the nipple or in the armpit.
2. A change in the appearance of the nipple or areola including a change in direction of nipple.
3. Nipple discharge or nipple sores.

Whilst sometimes men and boys can develop more breast tissue than normal due to a condition called gynaecomastia which is not related to cancer, it is important that if any change is noted a prompt visit is made to the GP who can check the symptoms and refer the individual for tests at the hospital clinic if necessary.

How is breast cancer in men treated?

Many treatments of breast cancer in men are the same as those used for women.  There are some differences but the three main methods are via surgery, radiotherapy and drug therapy.


Men with breast cancer will commonly undergo a mastectomy to remove the cancer, their breast tissue and often nearby muscle and most or all of the lymph glands in the armpit.  Whilst some women may undergo a lumpectomy this is less common in men because men have less breast tissue than women so breast tissue will often invade surrounding tissue unless caught early.


Radiotherapy is a very common treatment for breast cancer in men.  The aim is to destroy the remaining cancer cells and reduce the chance of cancer returning.

Drug therapy

To date there have been very few studies of the effectiveness of drug therapy for breast cancer specifically in men and consequently the drug therapy tends to be based on treatments that are known to work well in women.

Most breast cancers in men are known to be sensitive to hormones. This means that cancer may be stimulated to grow by exposure to the hormone oestrogen and progesterone.  Hormone therapies including tamoxifen block the action of these hormones and can increase men’s survival rate when used with other treatments.

Men are often also offered chemotherapy and the same regimes used in women.

Why are men diagnosed so late?

As previously mentioned, by the time the majority of men are diagnosed with breast cancer they are at stage 4 or 5 meaning that their survival rate over the 5 to 10 year period has dramatically reduced.

Whilst the full reasons for late diagnosis are not clear, men who discover a lump in their breast tissue often report a delay in going to see their GP. This may be due to a lack of awareness that breast cancer can also affect men or due to feelings of embarrassment and emasculation that they have contracted a disease which is often deemed to be a ’female’ disease.

Another possibility is that there is also a general lack of awareness amongst healthcare professionals of the possibility of a diagnosis of breast cancer in male patients leading to delays in referrals for investigation of typical symptoms.

Whatever the reason, as specialist clinical negligence solicitors we all to often see the results of a delay in diagnosing cancer and how this can lead to a worse outcome for the patient.  We hope that greater awareness of this disease amongst patients and healthcare professionals will reduce the number of late diagnoses of this disease.

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